High Expression of Bcl-2 Protein Predicts Favorable Outcome in Non-small Cell Lung Cancer: Evidence from a Systematic Review and Meta-analysis

Abstract

<b>Background:</b> The prognostic value of Bcl-2 protein expression in non-small cell lung cancer (NSCLC) isunder debate. We therefore systematically reviewed the evidence for Bcl-2 protein effects on NSCLC survivalto elucidate this issue. Materials and <br/><b>Methods</b>: An electronic search in Pubmed and Embase complementedby manual searches in article references were conducted to identify eligible studies to evaluate the associationbetween Bcl-2 protein expression and overall survival (OS) as well as disease free survival (DFS) of NSCLCpatients. Combined hazard ratios (HRs) with corresponding 95% confidence intervals (95%CIs) were pooledusing the random-effects model. <br/><b>Results</b>: A total of 50 trials (including 52 cohorts) encompassing 7,765 patientswere pooled in the meta-analysis regarding Bcl-2 expression and OS of NSCLC patients. High expression ofBcl-2 protein had a favorable impact (HR=0.76, 95%CI=0.67-0.86). In the group of Bcl-2 expression and DFS, 11studies including 2,634 patients were included. The synthesized result indicated high expression of Bcl-2 proteinmight predict good DFS (HR=0.85, 95%CI=0.75-0.95). <br/><b>Conclusions</b>: Our present meta-analysis demonstratedfavorable prognostic values of Bcl-2 expression in patients with NSCLC. Further prospective trails are welcomedto validate the utility of assessing Bcl-2 in NSCLC patient management.